Hip Preservation Program

The Hip Preservation Program at the George Washington University Hospital — the only program of its kind in the Washington, D.C. metropolitan area — is focused on helping patients postpone or even prevent the need for hip replacement later in life.

Chronic hip pain can have a negative impact on an active lifestyle. If left untreated, symptoms of hip pain can get progressively worse, sometimes leading to hip arthritis and eventual hip replacement at an uncommonly young age.

Our experienced team of orthopedic sports medicine and surgery physicians, physical therapists and radiologists use the latest research and a multidisciplinary approach to diagnosis common hip conditions and offer surgical or non-surgical treatment options that are right for you.

Non-Surgical Hip Treatment Options

Physical therapy

• Exercise: Your physical therapist will supervise and guide exercises to improve muscle strength and endurance, as well as to improve control of your core and hip during movement.
• Movement analysis: Your physical therapist will analyze common movement patterns related to everyday activities and sports-specific movements. He or she can provide guidance on improving these patterns and optimizing your posture to decrease stress on your hip.
• Manual therapy: Based on your evaluation, your physical therapist may include manual stretching or joint mobilization to maximize your hip mobility to allow for more pain-free range of motion with your everyday activities.
• Dry needling: Dry needling uses a small filament needle to treat painful muscles in order to decrease pain and spasm and improve flexibility and range of motion. Your physical therapist can use this technique to help reduce widespread pain around the hip.

Other physician-provided non-surgical treatments include ultrasound-guided:

• Cortisone injections
• Platelet rich plasma and stem cell injections
• Bursal injections

Surgical Hip Treatment Options

Hip arthroscopy

A minimally invasive technique in which a surgeon makes two or three small incisions around the hip to diagnose and treat various hip conditions using fiber-optic cameras and small surgical tools. Procedures include:

• Arthroscopic Labral Repairs and Reconstructions. The labrum is a key structure in the hip which helps provide stability and joint fluidity. Labrum repairs and reconstructions help restore function without removal. 
• Arthroscopic Hip Impingement Treatment. Impingement is the contact of two bones within the joint, causing labrum and cartilage injuries. Surgeons reshape the bone to avoid further damage and to prevent the possibility of a painful arthritic hip in the future. 
• Arthroscopic ligament repairs and reconstructions. Ligaments may also need to be repaired in the hip when they have been injured.

​Hip osteotomy for hip dysplasia

An osteotomy is a procedure in which a bone is cut. This treatment includes pelvic osteotomies, which can create better contact forces in the hip and improve pain and function. It can also reduce the risk of hip arthritis in the future.

Open and arthroscopic tendon treatment and repairs

This is a surgical procedure used to diagnose and treat conditions from inside a joint. Areas include:

• Hip abductor (gluteus medius/minimus). Hip abductor muscles help balance the body over your legs with every step. 
• Hamstring. Located on the back of the leg, hamstrings connect the pelvis to the leg bone and propel you forward as you walk and run. 
• Iliopsoas. This muscle is deep in the groin and can cause a snapping sound or sensation in the hip. Surgeons can reduce "snapping hip" arthroscopically.

Femoral rotational osteotomies

A procedure reserved for excessive femoral retroversion or anteversion (bone rotation). Developmental issues can twist the leg inward or outward, and occasionally, surgeons will need to correct the issue using a femoral osteotomy, otherwise known as a cut in the bone.

Post-Operative Hip Physical Therapy

The physical therapists with the GW Hip Preservation Program guide you through a specialized rehabilitation program following your hip surgery. This begins with a pre-operative appointment to review your history and provide a comprehensive overview of the program. The post-operative guidelines and expectations will be thoroughly discussed to maximize your success.

The ultimate goal of rehabilitation following hip surgery is to maximally restore the function of your hip in a safe and controlled manner to allow you to return to your previous activities. Physical therapists with the GW Hip Preservation Program also place a high amount of importance on educating you on your condition and teach you how to manage your hip for the long term.

Phases of post-operative hip physical therapy

• You will begin therapy the first week following your procedure, both in the clinic and in aquatic therapy. The main goal during this initial phase is to restore your range of motion, muscle function and walking pattern all while protecting the tissue repair.
• The next phase of therapy involves restoring your strength and balance using functional exercises to regain normal use of your hip for daily activities and movements.
• The following phases of therapy will be targeted toward the return to higher level activities such as yoga, jogging, cycling, and sports-specific exercise. Your physical therapist can discuss timelines based on your specific procedure and needs, and will customize this phase of therapy for your desired activities.